Lifestyle Deficiencies and Metabolic Health: “It’s the Metabolism, Stupid”

Or, the Go Kaleo Theory of Everything™.

Obnoxiously overdramatic visual.

My lightbulb moment: the day I understood that my body and my health were a reflection of my habits, and that in order to have a healthy body I needed to engage consistently, over time, in the behaviors that promoted health. The body needs certain conditions to be met in order to function optimally, most people ‘get’ this on a nutritional level. We understand nutritional deficiencies:

  • A Vitamin D deficiency leads to Rickets.
  • A Vitamin C deficiency leads to Scurvy.
  • A protein deficiency leads to Kwashiorkor.
  • A calorie deficiency leads to Marasmus.
  • A B12 deficiency leads to pernicious anemia.

Etcetera. We understand that these conditions are the result of fundamental needs not being met, and that the ‘cure’ is to meet that need. It’s not really a ‘cure’ though, it’s returning the body to homeostasis, the body’s natural state when the conditions for health are in place. We don’t further alter the diet or lifestyle to mitigate the symptoms of the deficiency. That would be silly. Lets consider what that might look like (cue dream-sequence harp music):

Imagine for a moment that you are dealing with the symptoms of a vitamin D deficiency. You’re experiencing bone and muscle pain, you’ve had a few bone fractures, and you’re developing multiple cavities. You find a blogger online who also has those symptoms, and that blogger has developed a novel new approach to addressing them: daily painkillers for the pain, using a scooter to get around to reduce the risk of falls (and subsequent fractures), and teeth removal to eliminate the cavity issue. Indeed, this approach seems to mitigate all of your symptoms! A miracle indeed! And no need to resort to pesky vitamin D supplements. Why supplement when you can simply take painkillers, pull out all your teeth, and use a scooter to get around? Deficiency be damned. You do some further investigation and discover that there’s a huge online community of people who’ve adopted this lifestyle to deal with their symptoms. Blogs, facebook pages, books, heck, there are even doctors who advocate this lifestyle! You fit right in. You join a few facebook groups, make some online friends, and settle in to your new lifestyle. There are even conferences and social gatherings where you can meet fellow ‘low-Ders’, exchange tips and stories, and generally receive affirmation and reinforcement for your lifestyle choices.

Of course this sounds absolutely absurd. But we do it all the time. Let me explain…

I had my lightbulb moment long before I’d heard of ‘evolutionary health’. At first, my understanding was nebulous and visceral. I sensed that I needed to create the conditions that my human body was adapted to in order to improve my health. You know, the way zoos try to recreate animals’ natural habitat in order to keep them healthy? You put a lion in a penguin habitat and pretty soon you’ve got a sick, or dead, lion. Well, I sensed that my ‘habitat’ and lifestyle wasn’t appropriate for my health. I was sick after all.

I began with simple logic. What conditions are humans adapted to? Remember, I hadn’t heard of evolutionary health yet. I was just thinking critically. What conditions were ubiquitous for our species as we evolved? I could only think of a few, as we’ve managed to thrive in so many different environments, and those few constants, as I saw them were:

High levels of physical activity.

I’ve since heard the speculation that primitive man’s life was largely sedentary, but this argument makes zero sense to me. Without technology to do the tasks of daily life, living is hard work, no matter how you slice it. Even the simple act of pooping requires physical exertion. Don’t believe me? Stop using a toilet to poop for a few months and see what happens to your thighs. Mmm-hmm. That’s right.

No, up until the last 50 years or so, when we started sitting down most of the time, life was hard work. Everywhere you went you walked, or later, rode a horse, but even that requires physical exertion. You carried things, you climbed things, you dug things up, you skinned animals, you chased prey (or ran from predators), you built shelters, you migrated to follow the seasons or the herds. And there was no TV or internet, so when you weren’t working your ass off in the pursuit of food and shelter, you DID stuff to keep yourself occupied. You danced, you played games, you made stuff with your bare hands, you explored. You never sat motionless for hours on end. That is a 20th century invention. Studies on modern-day hunter-gatherer societies show that even though their total energy expenditure is about the same as westerners, hunter-gatherers are significantly more physically active.

Our genome is evolutionarily adapted to high levels of physical activity. It just is. I hate to break it to you. Physical activity is a fundamental requirement for normal metabolic function, without adequate physical activity we develop insulin resistance and then a whole cascade of metabolic and endocrine dysfunction. I’m not pulling this out of my ass, or cherry picking data, by the way. The Mayo Clinic, Johns Hopkins, the NIH and the NDIC and other reputable scientific organizations agree that inactivity is a primary driver of metabolic dysfunction. Attempting to treat the symptoms of insulin resistance with extreme dietary restrictions, which is what SO MANY in the fad diet, ‘real food’ and ‘ancestral health’ community (which at this point has completely jumped the shark) are trying to do, is like treating the symptoms of vitamin D deficiency with pain killers and teeth pulling. Pain killers and teeth pulling may help in the short term, but establishing healthy vitamin D levels is what is necessary to return the body to ‘normal’ function. The answer is not to tailor the diet to one’s activity level, the answer is to maintain the activity level that supports healthy metabolic function. Otherwise you are merely treating the symptoms of the deficiency. The physical activity deficiency.

Sunlight and sleep.

Variations in skin color are an indication that our genome is adapted to sun exposure. The more sun a geographic location gets, the darker the skin of the people who traditionally inhabited that area. We require sunlight to synthesize vitamin D (there’s my analogy, lol), an essential nutrient for health, which indicates, to me at least, that sunlight has been a ubiquitous condition during our evolution. Same with sleep, we can’t be healthy without it. Attempting to circumvent the health ramifications of sunlight or sleep deficiency by simply addressing the symptoms would be foolish. If you have a sunlight or sleep deficiency, the solution is simple and obvious, get some sleep or sunlight. Fortunately we can get vitamin D from food, an adaptation to living in geographic areas with less sun exposure I’m sure, but just try to hack sleep deficiency. Not happening. We require these things to be healthy, because we’ve evolved under these conditions.

Whole or minimally processed foods.

For the vast majority of human history we’ve eaten foods in the form nature provides to them, or very close. Until the last century, processing of food was minimal: cooking, grinding, fermenting, drying, etc. Only recently have we begun extracting, isolating fractionating, hydrolyzing, etc. Given enough time we could surely adapt to these processes  (we are a highly adaptable species after all, a trait that accounts for our success), and in fact I think we can get away with eating some processed foods because we’re so adaptable (I do), but our bodies are adapted to absorbing and metabolizing nutrients in synergy with the other nutrients that occur together in whole foods, so eating mostly whole foods is probably best in the big picture.

That said, I’ve heard arguments that we’re evolutionarily adapted to specific macronutrient ratios, and I find this line of thinking completely ridiculous. Because we’ve found ways to thrive in almost every environment on earth, we’ve been able to adapt to the foods provided by those environments. The Inuits thrive on a diet of mostly fat, while the Kitavans thrive on a diet of mostly carbs. And somewhere on earth, you’ll find a culture that thrives on every macronutrient ration in between. We eat animals, we eat plants, we eat grains and legumes, we eat insects, we eat fungi, we eat crustaceans, we eat mollusks, we eat honey, we eat algae. And more. We like sweet things and we like fatty things. We’ve found ways to thrive on virtually anything the earth can provide. The common thread isn’t a macronutrient ratio, the common thread is whole, or minimally processed, foods.

Energy balance.

Here’s where I get really philosophical. I believe that any given environment provides a finite amount of caloric energy to support the life that exists there. The variation in human size from individual to individual (and from culture to culture) suggests to me that different ‘strains’ of humans evolved symbiotically with their environment. Environments that provided more caloric energy produced larger humans, and vice-verse. A person’s energy needs are directly proportional to their size (and to a lesser extent their activity level, but BMR makes up the lion’s share of our daily energy expenditure, and BMR is in direct proportion to body weight). When we consistently, over time, consume more or less energy than our body requires, we develop metabolic dysfunction. Too much energy leads to excess adipose storage, and excess adipose produces inflammatory compounds, excess estrogen, and drives insulin resistance. Insufficient energy intake leads to thyroid and reproductive hormone imbalance, fatigue, depression and insomnia, bone and organ deterioration, and a whole host of other issues. We’ve strayed from our natural relationship with our environment and the energy it provides. We have unlimited calories available to us for the first time in human history, and some of us go to the opposite extreme and decide to restrict our intake below what is necessary to sustain health. When we had a more symbiotic relationship with our environment, our bodies adapted to the energy resources it provided. We’re all out of whack now. And energy balance DOES matter. Anyone who claims otherwise is selling a magic pill.

There you have it. My Go Kaleo Theory of Everything™. Re-create the conditions we’re adapted to if you want to support metabolic health (because metabolism is, after all, everything). When I started out on this path five years ago it was an instinctive sense that I needed to change my behaviors and lifestyle conditions to improve my health. Over the years I’ve done research that has consistently reinforced my original instinct, so that at this point I’ve fleshed out my ideas with facts and scientific data. Putting my ideas into practice in my own life WORKED, not only did I lose weight, but I reversed PCOS and several other nagging conditions. I’m five years in and have maintained my weight loss and health by maintaining health-promoting lifestyle behaviors. I am not perfect in any area, but I am consistent in all of them. Day by day, habit by habit, I focused on changing my behaviors, not on changing my body. And new behaviors produced better health.

me·tab·o·lism

/məˈtabəˌlizəm/

Noun

The chemical processes that occur within a living organism in order to maintain life.

29 thoughts on “Lifestyle Deficiencies and Metabolic Health: “It’s the Metabolism, Stupid”

  1. I like your writing style and even more your healthy attitude. Regardless of our evolutionary history, there are intelligent foods that we can all eat with full confidence of assured nutrition, with minimal negative effects. I am just starting out on my “journey” towards a happier healthier life. In the eighties, (my twenties), I worked in health food stores in Los Angeles, California. So I have this sort of hodgepodge of experiences with many customers and their diets and food dogmas. Since I was from and am now back in the Midwest, the changes were slower toward healthier eating, but it is no longer considered as extreme of a lifestyle.
    Over the decades I have tried to be a vegetarian a few times and it has not worked out so well. I do agree with the quality and source of meat as being far more important than the assimilating “dangers” of animal protein and fat. My main hope is to not have a food centric life and the idea of eating the end result of a rather intense process of obtaining meat, will drop away. Eating better does move one away from the large portions of meat, (since when did the 1/2 burger become so ubiquitous?). The cravings are replaced by a better appetite and experience of the bounty of wonderful foods on this planet.
    So, it finally occurred to me that sprouting and eating, beans and seeds, is a very convenient and nourishing inclusion into the diet. They satisfy me and they have no added anything, just the addition of water. Sunlight is not even required. 1/2 cup of the bean mix (not going to do any free advertising here) yields about two cups of sprouts in two days and I eat about a cup a day. 2 tablespoons of the seed mix yield about three cups and takes about 4 1/2 days. These have to be de-hulled (rinsed or floated to skim off). I eat about 1 1/2 cups a day of these grassier sprouts. With only two sprouters I am alternating eating both kinds of sprouts and timing the process for best freshness. It is costing like 30 cents a day. There, I am passing this on to your readers.

  2. I love this Amber. I agree fully. You have changed my life with your realistic, science based way of thinking. Many thanks.

  3. Yes, there is more. This comment will turn away from consumption to activity, which I am horribly resistant to. I have contemplated the evolutionary diet of humanity all on my very lonesome. Yes, and I do not have PhD.

    My thoughts on fat and storage in the body have to do with a very erratic availability of food for many of our ancestral generations. Obviously, movement of clans or tribes followed food sources, most likely scavenging freshly killed carcasses, stuff dropping from the trees, and stubbing toes on tubers and all that. So, yes there was a high amount of activity, just to get the energy to get more food, for more energy and on and on. I reason that there may have been times of great abundance and humans would gorge and eat as much as possible. Then lay around and sleep it off, and then slowly start to go hungry again, as the stored fats were “eaten” away. 3 meals a day is a modern convenience, back then it was feast and fast and hopefully not famine. The body may have evolved, needing fasting as part of a larger metabolic span of time.

    So, tuning into oneself is not easy, but the way to complete physical, mental and spiritual health. Getting to know how you really feel and react takes time and many learning it all over again. It is unfortunate that it’s encouraged by mainstream society and the media to over indulge oneself in all of our glorious abundance, but one does pay the price.

    BTW, I’m not moving around much yet. Going for walks in the winter cold and some other minor activity. Maybe some of our ancestors virtually hibernated for a few months. In my case, Finland.

    You do inspire me, because I can see that you are honest and sincerely care about all of us

    • I was very resistant to physical activity as well. I can identify!

      I’m not at all impressed by the arguments for fasting. Human populations are most dense in tropical and temperate climates where food is available year round. And in places where food is seasonally scarce, I see this as simply more support for environmentally controlled energy balance. Energy intake was controlled over the course of the year rather than over the course of a day or week. There’s been no environment with unlimited energy availability until now. We are not adapted to it.

      Thanks for your input David, I’m glad you’re working on getting more active.:)

      • I am not a “faster”, but the general tone I get from it, is a resting for the digestive system. I don’t know all that you have said about this since I am new here, but not eating after a certain time at night, 6 pm until 6 am is definitely a goodly amount of time for the digestive system to “rest”. I have not read your take on balancing the energy input throughout a 24 hour period. Of course we are all different and should fine tune these things as we connect with our bodies.
        I will start a personal investigation into the amount of energy that is required for the body to actually digest food. I am sure it varies with what is consumed and how active one is.

        • Indeed! Highly thermogenic foods increase the metabolic rate, so when I have clients that eat a lot of protein and fiber, I tell them to eat more to ensure they’re getting enough net calories to support their activity.

  4. Thanks for a good and convincing argument.

    I have a vague hypothesis that lactate might be an “activity factor” that prevents metabolic inflexibility, and that there are a series of these substrates, including ketone bodies and anaplerotic TCA cycle substrates from amino acid catabolism, which are supplied by activity and fasting (anaplerosis and renewal of TCA reducing equivalents FADH2 and NADH might be the key to how this works). Stay in the fed state or the inactive state too long, the wind changes and you’re stuck like that.
    it’s probably no accident that ketotis coincides with inactivity (i.e. fasting while we sleep) in healthy people.

    • Very scientificy George. 🙂

      What you’re describing sounds to me like a very nitty gritty version of ‘adequate exercise + sleep + proper energy balance = healthy metabolic function’. Get any of those conditions ‘wrong’ and you’ve got metabolic trouble. Lactate production, the krebs cycle, etc, are, after all, functions of normal cellular metabolism.

      • The science is vague, I’m afraid, but the overall idea is that we evolved to run on a mix of substrates, not just fat and glucose, and some of the additional ones are produced by activity, fasting, and muscle anabolic-catabolic flux. And this diversity, in some approximate balance, maintains flexibility.

    • George, just wanted to stop in and say thanks for your thoughtful posts, you’ve given me some things to think about and a direction for future research and blogging. 🙂

  5. ” Re-create the conditions we’re evolutionarily adapted to if you want to support metabolic….”

    But we’re still evolving. And those conditions to which you refer are so varied geographically, and in terms of time I can’t see any commonalities except the one you reject: scarcity. Up until recently, it strikes me that food was dear and exercise was cheap. That’s why we didn’t get fat. (Unless we did, see Venus of Willendorf.)

    “Human populations are most dense in tropical and temperate climates where food is available year round.”

    Is this historically true? I don’t know about that. I have no idea what the climate was in Africa during the period of AMH’s “creation.” (I can’t think of another word than that. I do not use the word with any theological connotations.)

    I have zero expertise as regard the Paleolithic era but I do know it was (a) quite long (b) saw the rise & fall of several different forms of humanity and (c) was so varied that I hesitate to draw any definitive conclusions.

    • Yes, we’re still evolving. I touched on that when I said we could likely adapt to processed foods given a few more generations. And we’ve certainly adapted over the last few thousand years to eating dairy, grains and legumes, more recent introductions into our collective diets. We’ve had much longer exposure to those foods than to inactivity.

      And I agree with you on the ubiquity of scarcity, I just framed it as ‘environmentally controlled energy balance’ instead of the more blunt ‘scarcity’. We’re clearly adapted to an energy controlled diet.

      And I also agree with you on your last point, our evolutionary history is incredibly varied, which is why the only constants I can see are physical activity, sleep and sunshine, whole foods and energy balance (or scarcity).

      • I resist the too-sanguine view that “we” evolve in this way. “We” suffer and die , become infertile – the descendants of any survivors have evolved..
        We could evolve more easily and quickly by using our big brains to realize this crap food is not for us, and using our highly developed culture to suppress it.
        IMO

        • Totally agree. Just because we probably CAN adapt to inactivity and processed food over the course of several generations, I don’t think it’s really a good idea.

          • At this point I am rather skeptical of all attempts to learn from the Paleolithic era. I’ve been watching Plant Positive’s videos. While I am in no danger of becoming a vegan, I think he makes some devastating criticisms of the Paleoists.

            My takeaway on all this is, we adapted to this, to that, to the other thing…it’s all very interesting but if we want to know what works for now, we would be better off studying modern peoples rather than making speculations about what people 80K years ago lived on. Don’t get me wrong, what they did 80K years ago is interesting, but I’m more interested in seeing how the Japanese have adapted to modernity.

          • I’m not talking about the paleolithic era, Diana. I’m talking about ALL of human history. Even 100 years ago we were significantly more physically active than we are today, and ate foods in their whole form, and didn’t use sunscreen and didn’t have electric lights to keep us awake into the night.

            And we DO study modern people, all of the studies I ever link to are done on modern people. Exercise is very highly correlated with reduced occurrence of insulin resistance and metabolic dysfunction. That’s not paleo. That’s modern science.

      • Also, to adapt to one thing often has costs in terms of another.
        Adapting to malaria selects genes for sickle-cell anaemia, thallesaemia, favism. Adapting to gluten, for example, might involve an element of immunosupression that renders us more vulnerable to the next plague.

        • “Also, to adapt to one thing often has costs in terms of another.”

          Interesting insight. In fact I would change the word “often” to “always.”

          But I don’t agree with you about gluten, unless you can be more specific. We are all immunosuppressed (or perhaps immuno-challenged might be a better word for it) in some form or fashion. Just take a look at the 1918 “Spanish flu” epidemic. Or any flu epidemic. A novel virus comes up and….

          • Well interferons stimulate gut sensitivity to gliadin, which is why gluten sensitivity is often a post-viral phenomenon. Conceivably an adaptation with weaker interferon response would be more tolerant of gluten, but susceptible to some pathogens or cancers.
            An interesting anthropological question is whether western diseases decimated newly colonized peoples before or after these were affected by new foods or food shortages, and if so, which diseases were diet-dependent and which spread independently of nutritional factors.
            Major smallpox epidemics among native peoples, for example, in USA and NZ seem to have occurred subsequent to colonial transitions, not at first exposure.
            But this is a subject that deserves a careful review, and may tell us something fundamental about the interaction of diet and immunity.

          • This is a reply to George @ the Hight Fat Hep C Diet write:
            “Major smallpox epidemics among native peoples, for example, in USA and NZ seem to have occurred subsequent to colonial transitions, not at first exposure.”

            According to what I have read, “subsequent” was not an issue. I would like some clarification.

            http://en.wikipedia.org/wiki/1491:_New_Revelations_of_the_Americas_Before_Columbus

            excerpt part one:

            “The Inca Empire collapsed because by the time Europeans arrived, smallpox and other epidemics had already swept through cities, due both to population density and mostly to the natives’ lack of immunity to Eurasian diseases.”

            I could do more research and I respect George @HFHCD, but I do think that much of the Native Americans died preceding the second wave of Old World arrivals

          • Thanks Dave, it was just a question. I was listening to a radio program about the smallpox epidemic decimating Maori in NZ in 1913 and thought, “that seems a bit late if it’s just about immunity”.

            So I wondered what the story was elsewhere.
            Smallpox of course was a lethal disease for Europeans in 1500s, by 1800s and colonisation of NZ a large % of Europeans would have been vaccinated with cowpox.
            This might have been what delayed the NZ epidemic, and may have made a difference in Western North America, which was settled relatively late.

            The 1491 book looks interesting. I really enjoyed Prescott’s two histories “The Conquest of Mexico” and “The Conquest of Peru” when I was younger. I will look for this at the library.

          • It occurs to me that when I was younger I completely misunderstood the first contact immunity differential. I assumed that the relative lack of immunity of isolated peoples was due to the lack of some genetic adaptation caused by generations of exposure that protected the explorers.
            Actually, what protected the explorers, was the fact that many of them had already survived the diseases. They had a high rate of immunity and also some benefit of herd immunity. Once a disease like smallpox jumped to an isolated native population there were no immune individuals to avoid infection and therefore limit its spread.
            On the other hand, some infectious illnesses such as tuberculosis have long been associated with malnutrition and treated with improvements in diet. http://www.ncbi.nlm.nih.gov/pubmed/19391442
            Think of all the artists writers and composers who died of TB – none were able to, or choose to, eat well.

  6. Hi Amber, been following (stalking, lol) you for some time. I really like your way of thinkining! One of the few ‘voices of reason’ on the ‘fitness-bandwagon’. Wish more people would start thinking for themselves (like you did), do proper research and then make their own decisions regarding their health and fitness. Keep up the good work!!

  7. Hi Amber, been following (stalking, lol) you for some time. I really like your way of thinking! One of the few ‘voices of reason’ on the ‘fitness-bandwagon’. Wish more people would start thinking for themselves (like you did), do proper research and then make their own decisions regarding their health and fitness. Keep up the good work!!

  8. Arm chair scientist that I am. I figure I may as well mention my simplistic understanding of pathogenic ecology. A disease, be it viral or bacterial, as deadly as it can become, somehow “knows” not to completely kill of the host or the at least the whole tribe. The would render the symbiotic relationship moot. So the complex involvement between diseases and their hosts has significant ingredients of time and location. Old Worlders crossing the Atlantic and exposing the New Worlders would abrogate this relationship

    • The disease will have adapted – if it is of long-standing and/or high mutagenicity (which is not the case with all infectious diseases) – to be optimally exploitative (to spread effectively without too much host harm) in a given environment.
      For example, HCV evolved to deplete selenium for host epigenetic purposes, if it spreads to a population where selenium status is unusually low it will become more pathogenic.

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